Welcome Packet Order Form

First Name	Last Name	Spouse First Name	Spouse Last Name
Street Address	City	State	Zip
Home Phone	Business Phone	E-mail Address
Expected Arrival Date		Best Time to Drop Off Welcome Packet

I would like a visit from a local church pastor.
		Baptist Lutheran United Church of Christ Other: No Preference

I need to open an account prior to my arrival Please send me information on the following: Checking Accounts Savings Accounts Loans Investments Insurance

List any additional information you would like for us to send:

I understand that by submitting this form I am authorizing the State Bank of Alcester to release my name and address to a Welcome Packet Delivery Person. If I have checked that I would like a visit from a pastor, my name and address will be released to a local pastor as indicated. My personal information will not be shared with any other affiliates of the State Bank of Alcester.